petdiabetesfandomcom-20200216-history
Caninsulin
CaninsulinCaninsulin-Pharmacokinetics, manufactured by Intervet and known in some countries as VetsulinVetsulin Website, is a veterinary porcine lente insulin, made up of 30% semilente (short-acting) and 70% ultralente (long acting) insulins. It is a suspension of crystalline (ultralente) and amorphous (semilente) insulins in the ratio shown above, as are all Lente insulinsEMEA Scientific Discussion Monotard. Vetsulin is Intervet's US brand name for Caninsulin. Iletin II LenteUS-FDA Iletin II Lente Discontinuation Material 2003 by Eli Lilly and Monotard Pork by Novo Nordisk were pork lente insulins. The difference between them is: Vetsulin/Caninsulin is made by Intervet for veterinary use and is a U40 strength insulin--the Lilly and Novo insulins were U100 strength. At present in the US, Caninsulin is FDA-approved for use only in dogs under the trade name Vetsulin. However, it is often used in the US "off label" for cats too. According to US law, any drug--whether it is approved for humans or animals--may be legally used in treatment(s) other than those which the drug received its approval(s) for. Everyone using non-veterinary insulins in the US for their pets is technically using them legally off-labelPetPlace.com-Insulin-Precautions & Side Effects. How it works in dogs The majority of dogs on Caninsulin/Vetsulin (two-thirds) also will require twice-dailyVetsulin Insulin RequirementsCaninsulin-Twice Daily Regimen for Dogs & Cats (Page 6) injections. Intervet says that many dogs stabilize better on twice-daily insulin injections. They also point out that when shots are given twice instead of once daily, there are less hypoglycemia incidents and better blood glucose controlCaninsulin-Starting Insulin in the Healthy Diabetic Patient (Page 4)Effect of Insulin Dosage on GlycemicResponse in Dogs with Diabetes Mellitus: 221 cases (1993-1998)-Journal of the American Veterinary Association-2000. Most vets are also not in favor of once-daily use because it is harder to regulate a dog on once-daily insulin than twice-daily dosingBD Diabetes-Insulin Injections for Dogs. Caninsulin/Vetsulin is a lente insulin, which is classed as intermediate, not long acting. Long acting insulins (such as Lantus,Fleeman & Rand-Comparison of Pharmacodynamics & Pharmacokinetics of Glargine (Lantus), Protamine Zinc (PZI) & Pork Lente in DogsSelecting an Insulin for Treating Diabetes Mellitus in Dogs & Cats-Nelson-OSU Endocrinology Symposium 2006 Page 40 Ultralente, PZI) have a poor success rate among dogs. http://www.caninsulin.com/images/insulinactivitydog.jpg For those with dogs, here is a graph of the canine activity. This blood glucose graph of Somogyi rebound shows a dog on once-daily porcine lente injections. You can see how the large insulin dose in once-daily regimens produces a steep low at insulin peak. Note: values are shown in mmol/l (non-US) measurement. http://www.vin.com/ImageDBPub/TN20000/TN_IMC16198_550X0Y.jpg Contrast this with a blood glucose graph with a twice-daily insulin regimen where food and insulin are given on a 12 hour basis. Note: values are shown in mmol/l (non-US) measurement. http://www.vin.com/ImageDBPub/TN20000/TN_IMC16196_550X0Y.jpg How it works in cats Caninsulin is intended for dogs, but works (somewhat differently) in cats too. Note that feline usage is "off-label" in the US. Caninsulin is a BID (two times a day) insulin in catsCaninsulin-Twice Daily Regimen in Dogs and Cats (Page 6), due to the faster metabolism of the catCaninsulin-Starting Insulin Therapy in the Healthy Diabetic Patient (Page 4). The fast drop experienced by cats is a drawback. (Note the glucose drop from 25.0mmol (450mg) to about 7.5 (135mg) in just four hours, advertised by the manufacturer as typical in cats.) Because of the harshness of that initial drop, it may be important in cats to time shots together with meals. http://www.caninsulin.com/images/insulinactivitycat.jpg Some cats can have good results with Caninsulin despite this drawback, or even make good use of it, as shown in the case of Butterscotch. See his case and other feline Caninsulin-Vetsulin cases also. Technical details Caninsulin is an aqueous suspension of insulin containing 40 IU per ml of highly purified porcine insulin (Lente); 30% is amorphousMerck Manual Amorphous Definition (non-crystallized) zinc (Semilente) insulin and 70% crystalline (in crystal form) zinc (Ultralente) insulin. The difference between Caninsulin and both Iletin II LenteIletin II Lente-Lente Pork Insulin Remedyfind.com made by Eli Lilly and Monotard PorkEvaluation of an Insulin Zinc Suspension for Control of naturally Occurring Diabetes Mellitus in Dogs-Australian Veterinary Journal-2000 (Page 3) made by Novo Nordisk is this: Caninsulin/Vetsulin is a veterinary insulin of U40 strength. Both Novo's and Lilly's insulins were U100 strength. No Lente-type insulin regardless of species can contain any NPH/isophane insulinCombining Lente-type Insulins with Phenol-Preserved Insulins or any R/Neutral insulinLente Zinc Suspension Causes Loss Of R/Neutral Short-Acting Effect. Both are chemically impossible: the phenol preservative present in NPH/isophane alters the action of Lente-type insulins, creating a mixture with an approximate action of R/Neutral. The zinc suspension of Lente-type insulin binds R/Neutral, causing the short-acting insulin to slow, losing its short-acting effectIntermediate-Acting Insulin Preparations: NPH (Isophane) & Lente Diabetes Care-1980 Note--in 1980, there was only beef Lente-type insulin--no pork or r-DNA/GE/GMLente insulinsSolubility Changes on Mixing Short- and Long-acting Insulin Preparations-South African Medical Journal-1988. Caninsulin contains porcine insulin. Porcine insulin is identical to canine insulinIntervet-Caninsulin-Product Information, but differs from human insulin in respect of one key amino acid. Porcine insulin differs from feline insulin in 3 amino acid positions shown in the table belowAmino Acid Sequences. Insulin Amino Acid Differences Further Information It is a veterinary use prescribed insulin and in most countries must either be purchased directly from your vet or with a prescription. A human pharmacy will not have it, and you must get a prescription. In Canada, Caninsulin is available OTC, or over the counterPetPharm.org-Canadian Shipping Only for Caninsulin online. It is also available online with a prescription1800 PetMeds WebsiteBestPet Pharmacy--UK Only in some countries, and may cost less that way. Caninsulin and Vetsulin can be purchased in two ways: a pack of ten 2.5ml vials and the more traditional 10 ml vial. Cats and and small dogs can get new vials monthly without wasting. http://www.intervetusa.com/images/product_photos/VetsulinNew%20frame.jpg http://www.intervet.fr/Binaries/71_94832.jpg Vetsulin in ten 2.5ml vial pack French Caninsulin syringes. and 10ml vial. Because Caninsulin is is a U40 insulin, U40 syringes are the most helpful. If you choose to use a U100 syringe, you must do the U40 to U100 conversionFDMB-Using U40 Insulin in a U100 Syringe. The conversion is not difficult and can give you precision of 0.2 units for those animals needing a more precise dose. http://pets.intervet.it/binaries/96_104633.jpg Caninsulin/Vetsulin branded syringes do not appear the same world-wide. Above is a photo of Caninsulin syringes sold in Italy; French Caninsulin syringes are shown above. Further Reading *Pharmacology of a U40 Porcine Lente Insulin Preparation in Diabetic Cats--Journal of Feline Medicine & Surgery-Rand & Martin-2001 *Efficacy & Safety of a Purified Porcine Insulin Zinc Suspension for Managing Diabetes Mellitus in Dogs-JAVMA-Dr. Laxton, et. al.-2005 *Horn-Mitten study from Australian Veterinary Journal, citing Church's study equating Caninsulin with Monotard Pork, thus the need for two shots a day in dogs. *Australian Veterinary Journal-Drs. Horn & Mitten Respond to Caninsulin Once-Daily Dosing Claims for Dogs * Caninsulin web site * Vetsulin web site * Buy vetsulin online, perhaps cheaper than at your vet *PetPharm offers Caninsulin as an over the counter (OTC) medication. Their policy is to ship insulin within Canada only with deliveries made by courier. *Best Pet Pharmacy is online and UK-based, serving the UK and Northern Ireland only. As of October 31, 2005, UK law abolished all charges vets could make for writing prescriptions so one could possibly obtain medications cheaper elsewhere. All insulins in the UK are considered POM--prescription-only medicationsList of POM Veterinary MedicationsCurrent Veterinary POM Medications-UKDTI-UK-Page 3. Abolition of the fees for writing prescriptions makes it possible to obtain one and then shop with them online. *Use in rabbits Though not licensed/approved for use in rabbits, Intervet presents some helpful information on using Caninsulin/Vetsulin for them. *Click Here For Photo of Caninsulin Syringe With Magnifier *Intervet UK-Caninsulin Product Data Sheet References Category:InsulinsCategory:intermediate-actingCategory:Lente Category:VeterinaryCategory:porcineCategory:Rx StatusCategory:OTC Status